Oregon Health & Science University's hub Brain Research/Acute Interventions: Neurological Emergencies Treatment Trials (BRAINETT) is applying for a renewal of its role in the Neurological Emergencies Treatment Trials (NETT). BRAINETT has successfully participated in all four NETT clinical trials, enrolling a total of 98 patients. BRAINETT's participation in national NETT activities has included Dr. Warden's leading role on the NETT EMS Committee that was charged with developing new pre-hospital studies. The OHSU hub team has been recognized for its commitment to carrying out the Exception from Informed Consent (EFIC) process for two NETT studies by being invited to participate in a national conference on EFIC and a new RO1 application to study best practices for EFIC research. In the next five years, BRAINETT will build on its successes and learn from its challenges. The specific aims of this proposal are to: 1. Continue BRAINETT's strong participation in NETT trials through an expanded network of investigators, research staff, clinical collaborators and other partners; 2. Develop additional strategies to optimize communication and expedite administrative activities; and 3. Contribute to the impact and effectiveness of the national NETT effort. The addition of three new spokes to the network, including the University of Washington (UW) Medical Center and UW-affiliated Harborview Medical Center in Seattle, WA, and Peace Health Southwest Medical Center of Vancouver, WA will greatly increase the size and diversity of the patient pool. PUBLIC HEALTH RELEVANCE: The NETT network of interventional studies of neurological emergencies addresses straightforward treatments for common illnesses and injuries that often result in significant morbidity and mortality. The NETT studies identify early intervention methods to prevent the cascading effect of brain injury from seizures, strokes, transient ischemic attack, and traumatic brain injury.